Health care resource utilization and treatment of leptomeningeal carcinomatosis in the United States.

摘要: Background The economic burden of cancer in the United States is substantial, and better understanding it essential informing health care policy innovation. Leptomeningeal carcinomatosis (LC) represents a late complication primary spreading to leptomeninges. Methods IBM MarketScan Research databases were queried for adults diagnosed with LC from 2001 2015, secondary 4 cancers (breast, lung, gastrointestinal, melanoma). Health resource utilization (HCRU) treatment quantified at baseline (1-year pre-LC diagnosis) 30, 90, 365 days post-LC diagnosis. Results We identified 4961 cases (46.3% breast cancer, 34.8% lung 13.5% gastrointestinal 5.4% median age was 57.0 years, 69.7% female 31.1% residing South. Insurance status included commercial (71.1%), Medicare (19.8%), Medicaid (9.1%). Median follow-up 66.0 (25th percentile: 24.0, 75th 186.0) total cumulative costs highest subgroup ($167 768) lowest ($145 244). There considerable variation 89.6% patients who used adjunctive treatments 1 year, including chemotherapy (64.3%), radiotherapy (57.6%), therapeutic lumbar puncture (31.5%), Ommaya reservoir (14.5%). main cost drivers year ($62 026), radiation therapy ($37 076), specialty drugs ($29 330). prevalence neurologic impairments 46.9%, radiculopathy (15.0%), paresthesia (12.3%), seizure episode/convulsive disorder not otherwise specified (11.0%), ataxia (8.0%). Conclusions devastating condition an overall poor prognosis. present largest study this real-world study, current treatments, emphasis on HCRU. significant costs.